Abstract
Phthisis bulbi is an irreversible cause of visual loss with insufficient evidence about its aetiology and status of patients' fellow eyes. To identify the distribution of patients with phthisis bulbi and determine the status of their fellow eyes at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. We analysed data retrospectively retrieved from medical records of patients diagnosed with phthisis bulbi at initial clinic visit from January 2008 to December 2017. Information abstracted included biodata, laterality of phthisical eye, duration and aetiology of phthisis bulbi, visual acuity, and morbidities present in fellow eyes. Seventy-nine patients presented with unilateral phthisis bulbi. The mean age was 51±21.2 years and forty (50.6%) were males. The commonest aetiologies of phthisis bulbi were trauma 37 (46.8%), infection 17 (21.5%) and uveitis/inflammation 11 (13.9%). Seventy (88.6%) patients had morbidities in their fellow eye such as glaucoma 26 (32.9%), refractive errors 23 (29.1%) and cataract 22 (27.9%). Forty (50.6%) patients were either visually impaired or blind in their fellow eye (p=0.001). The commonest cause of phthisis bulbi was trauma. Approximately nine out of ten patients had ocular morbidities in their fellow eye. A thorough follow-up of patients with phthisis bulbi is recommended.
Highlights
Phthisis bulbi is an end-stage ocular disease characterized by atrophy, shrinkage, and disorganization of the eyeball and its intraocular contents.[1, 2] This usually results in visual loss as well as ocular disfigurement.[3,4,5] TheAfrican Health SciencesAfrican Health Sciences, Vol 21 Issue 1, March, 2021In sub-Saharan Africa, the prevalence of blindness from phthisis bulbi ranges from 4 – 19%.3, 14, 15 In Nigeria, phthisis is the seventh leading cause of blindness (0.1%) and severe visual impairment (0.007%).[16]
Of 19,852 clinical records for eye patients with different morbidities presenting for an initial visit to the facility during the study period, 79 patients were diagnosed with phthisis bulbi
Our findings showed that based on visual acuity, there were higher proportions of visually impaired or blind fellow eyes among patients who were 45 years or older (n=31, 39.2%; p=0.015), those who had non-traumatic causes of phthisis bulbi (n=26, 32.9%; p=0.033) and those with ocular morbidities in their fellow eye (n=40, 50.6%; p=0.001)(Table 4)
Summary
Phthisis bulbi is an end-stage ocular disease characterized by atrophy, shrinkage, and disorganization of the eyeball and its intraocular contents.[1, 2] This usually results in visual loss as well as ocular disfigurement.[3,4,5] TheAfrican Health SciencesAfrican Health Sciences, Vol 21 Issue 1, March, 2021In sub-Saharan Africa, the prevalence of blindness from phthisis bulbi ranges from 4 – 19%.3, 14, 15 In Nigeria, phthisis is the seventh leading cause of blindness (0.1%) and severe visual impairment (0.007%).[16]. In Nigeria, phthisis is the seventh leading cause of blindness (0.1%) and severe visual impairment (0.007%).[16] there is insufficient data on the distribution, the pattern of presentation of phthisis bulbi among general eye patients, and the status of their fellow eyes in sub-Saharan Africa and Nigeria. The objective of this study was to determine the prevalence, distribution, and clinical presentation of phthisis bulbi in a tertiary eye-care setting, with emphasis on the aetiology of phthisis bulbi, as well as the visual and ocular status of their fellow eyes. This will give insight into the need for the prevention of visual impairment and blindness in the only eyes of affected individuals.
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